Provider Demographics
NPI:1407975733
Name:BOWSER, GALEN KENT (DC)
Entity Type:Individual
Prefix:
First Name:GALEN
Middle Name:KENT
Last Name:BOWSER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-2925
Mailing Address - Country:US
Mailing Address - Phone:724-548-8444
Mailing Address - Fax:
Practice Address - Street 1:327 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2925
Practice Address - Country:US
Practice Address - Phone:724-548-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007734-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU79852Medicare UPIN
PA036971Medicare ID - Type Unspecified